Washington, 5 May 1997 (RFE/RL) - The World Health Organization says chronic diseases that kill millions of people a year will impose increasing "burdens of suffering" on hundreds of millions more over the next 25 years. The outlook is "particularly serious" for the former Soviet Union, Central and Eastern Europe.

Dr. David Brandling-Bennett, a deputy director of the WHO, says the unhealthy behaviors of large numbers of men and women in the former Soviet republics and central and eastern Europe are major factors in the predicted increase in ailments such as heart disease and lung cancer.

He cites very high rates of smoking throughout the region, unbalanced diets and a lack of physical activity as the behaviors most frequently linked to heart disease and several forms of cancer, including lung cancer.

The official spoke as the WHO, a United Nations agency, released a document called "World Health Report 1997: Conquering suffering, enriching humanity." The report was made public Sunday.

"The outlook is a crisis of suffering on a global scale," WHO Director-General Hiroshi Nakajima said in the report. "There is an urgent need to improve our ability to prevent, treat and, where possible, to cure these diseases, and to care for those who cannot be cured."

Heart disease and strokes kill more than 15 million people a year now, while all forms of cancer and respiratory ailments cause more than nine million deaths annually, the WHO says. These conditions are called non-communicable diseases, or diseases that cannot be passed from person to person. Contagious diseases, those caused by infection and parasites, account for 17 million deaths annually.

The WHO predicts that by the year 2020, there will be a 40 percent increase in cancer in the industrialized countries of the world. The industrialized nations will still face serious threats from infectious diseases as well because of the globalization of travel, tourism and trade.

At a Washington press conference, Brandling-Bennett said the former communist countries are facing what he calls the double burden of non-communicable and contagious diseases with weakened resources.

He said the public health establishment is still struggling to recover from the collapse of the command economy system and the switch to free market economies. The public health systems and the medical establishments can no longer count on government subsidies, and some countries are facing gaps in basic medical services.

Lung cancer poses a particular threat to women in the former communist countries.

Dr. Annie Sasco of the WHO's Cancer Control Program in Geneva said occurrences of lung cancer among women in the region are comparatively low right now. However, in a telephone interview with RFE/RL, she said the rate of increase of lung cancer among women could be as high as 30 percent in the next two decades. And she blamed a major increase in cigarette smoking among women.

Dr. Sasco said it will take that long for the harmful effects of smoking are seen. She compared the situation in the former communist countries today to the United States of three decades ago, when cancers traced to smoking were increasing annually.

The U.S. began a major, government-backed anti-smoking campaign more than 30 years ago. That included bans on cigarette advertising on television, explicit warnings printed on cigarette packages about the dangers of smoking, and public health education programs.

The U.S. federal government, governments in the 50 states and many non-profit anti-smoking organizations are continuing these efforts. In the past few years, 41 states and the federal government have enacted laws forbidding smoking in public buildings, taxes on cigarettes have been increased to make them more expensive and strict laws are in place to prevent children under 18 years from buying cigarettes.

The result has been a sharp drop in the number of people who smoke cigarettes in the U.S. and a decrease in lung and other cancer rates.

Dr. Sasco said that, in contrast, the nations of eastern and central Europe and the former Soviet Union "are at different point in the history of smoking and therefore also at very different point in the lung cancer epidemics."

She added that, while exposure to some substances such as asbestos and possibly air pollution may lead to development of lung cancer, "smoking is by far the major risk for lung cancer."

"The individual has a very important role to play (in deciding) to smoke or not to smoke to smoke," Dr. Sasco said, "and therefore exposing himself or herself to what is still the main cause of lung cancer."

The WHO report also projected a 40 percent increase in prostate cancer for men in the region over the next 25 years.

The prostate is a cluster of glands near the bladder. It has a tendency to become enlarged in men after the age of 45, and this can lead to the development of cancer. There are no symptoms, however, so doctors recommend an annual rectal examination for men over the age of 50. If it is detected in time, it can be controlled.

Dr. Sasco said prostate cancer is more likely to occur in men who are obese, who eat a diet that is too rich in animal fats and who do not get enough physical activity.

The WHO report called for an "intensified and sustained" campaign to encourage healthy lifestyles and attack the main risk factors considered chiefly responsible for heart disease and cancers.